Organization
STOP AND SHOP SUPERMARKET CO LLC
Active
Other names
STOP AND SHOP PHARMACY #695
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
275 HIGHLAND AVE, CHESHIRE, CT 06410-2522
(203) 272-3697
(203) 272-4569
Mailing address
275 HIGHLAND AVE, CHESHIRE, CT 06410-2522
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PCY1994
CT
333600000X
Pharmacy
PCY1994
CT
3336C0003X
Community/Retail Pharmacy
Primary
PCY1994
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004251922
—
CT
01
—
0720323
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
10/24/2011
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